Tıp Fakültesi / Faculty of Medicine

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Author: search.filters.author.Ozdemir, Binnaz HandanSubject: search.filters.subject.Immunosuppression

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    Colon Biopsy Findings of Renal Transplant Patients
    (2016) Tastepe, Firdevs Zeynep; Ozgun, Gonca; Ozdemir, Binnaz Handan; Tepeoglu, Merih; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-9894-8005; 0000-0002-3462-7632; 27805519; AAJ-8097-2021; AAK-5222-2021; AAJ-8097-2021
    Objectives: The purpose of this study was to evaluate colonic pathologies in renal transplant recipients. Materials and Methods: Patients with colon biopsies were selected from 1816 renal transplant recipients from January 1990 to December 2012 at Baskent University Hospital (Ankara, Turkey). Demographic and clinical findings with colon biopsies were examined. Results: There were 84 patients who had colon biopsies after renal transplant. There were 57 male and 27 female patients (median age at renal transplant was 33 y). Chronic diarrhea was the most common clinical finding at the time of colon biopsy. The median interval from renal transplant to first colon biopsy was 48.1 +/- 47.5 months. On microscopic evaluation, there were no pathologic changes in 17 patients. The remaining 67 patients had colitis (38 patients), polyps (17 patients), cytomegalovirus colitis (8 patients), and amyloidosis (4 patients). The mean interval between transplant and the diagnosis of colitis was 49.08 +/- 42.6 months, amyloidosis was 47.5 +/- 79.28 months, cytomegalovirus colitis was 5 +/- 3.5 months, and polyps was 77.65 +/- 58.8 months. There was a statistically significant difference between biopsy diagnosis and the time interval between transplant and colon biopsy (P <.01). Among 84 renal transplant recipients with colonic biopsies, 40 patients never had acute rejection episodes and 44 patients had at least 1 acute rejection episode. Seven of 8 patients with cytomegalovirus colitis, 19 of 38 with colitis, 3 of 4 with amyloidosis, and 5 of 17 with polyps had acute rejection episodes. Conclusions: In our report on colonic manifestations in renal transplant recipients, the most common colonic lesion was noninfectious colitis. Cytomegalovirus colitis is an important infection that affects immuno-suppressed individuals, such as transplant recipients. Cytomegalovirus must be kept in mind, and thorough sectioning and immunohistochemical staining should be used if necessary in the presence of any clinical or histologic suspicion for infective colitis.
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    De Novo Malignant Neoplasms in Renal Transplant Patients
    (2016) Akcay, Eda Yilmaz; Tepeoglu, Merih; Ozdemir, Binnaz Handan; Deniz, Ebru; Borcek, Pelin; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-9894-8005; 0000-0002-7528-3557; 0000-0001-6831-9585; 27805524; AAJ-8097-2021; AAK-5222-2021; X-8540-2019; AAK-1960-2021
    Objectives: The aim of this study was to evaluate the incidence of posttransplant malignancy in kidney transplant patients and investigate the clinical and histopathologic features of these patients. Materials and Methods: We retrospectively reviewed information on donor and recipient characteristics, patient and graft survival, and cancer incidence after transplant for 867 kidney transplant patients. Patients with neoplasms prior to transplant were excluded. A follow-up study estimated cancer incidence after transplant. Results: Neoplasms were diagnosed in 59 patients (6.8%), 41 men and 18 women; 22 (37.3%) had skin tumors, 19 (32.2%) had solid tumors, 10 (16.9%) had posttransplant lymphoproliferative disorders, and 8 (13.6%) had Kaposi sarcoma. The mean age at the time of malignant tumor diagnosis was 42.7 +/- 13.6 years, and statistically significant differences were found between tumor groups (P < .01). The average latency period between transplant and diagnosis of malignant tumors was 99.8 +/- 56.9 months for solid tumors, 78.4 +/- 52 months for skin tumors, 64.5 +/- 48.8 months for posttransplant lymphoproliferative disorders, and 13.5 +/- 8.8 months for Kaposi sarcoma, with significant difference found between tumor groups (P < .01). Ten patients (16.9%) had more than 1 malignant tumor. Eighteen patients died, with a mean time to death of 31.5 +/- 22.8 months after tumor diagnosis. A significant positive association was found between survival and the number of tumors (P = .001); 5-year survival after tumor diagnosis was 81% and 40% for patients with 1 malignant tumor and patients with more than 1 malignant tumor, respectively. Conclusions: Malignancy is a common cause of death after renal transplant. Early detection and treatment of posttransplant malignancies is an important challenge. Screening these patients for malignancies posttransplant is crucial, and efforts should be directed to define effective immunosuppressive protocols that are associated with a lower incidence of malignancy.